Obsessive compulsive disorder in children and its relation to subclinical anxiety symptoms in immediate family members

Abstract

This study examines the familial context in which childhood Obsessive Compulsive Disorder (OCD) develops. Through examining the familial environment of the OCD child, including parental OCD and psychopathology, Expressed Emotion (EE), and social support, it may be possible to identify characteristic patterns that facilitate the identification and treatment of childhood OCD. Forty children with OCD and their parents were recruited to participate. Children completed measures of OCD, EE, and perceived social support. Parents completed measures of OCD, general psychological distress, and the family environment. Family environments that emphasize control, dependence, and achievement may foster OCD behaviors. Parents may be viewed as more irritable, though this may be associated with the tendency of adolescents to believe that others generally feel negatively toward them. Daughters with OCD felt their parents were more intrusive, critical, and irritable. Parents participating in the children's treatment were viewed as less critical. The severity of the children's obsession and compulsions were not significantly correlated with the severity of their parents' obsessions and compulsions. There were some significant relationships among the types of OCD symptoms reported by the children and their parents, including means for protecting oneself from harm and for combating powerlessness. Some related symptoms may be forms of imitation while others are various manifestations of underlying themes. The severity of the parents' general psychological problems was not significantly correlated to the children's OCD symptoms. There was no significant relationship between the severity of the children's OCD symptoms and the levels of perceived social support. Higher levels of perceived parental irritability were the best predictor of the severity of the children's obsessions. Higher levels of familial control and of overall social support were the best predictor of the severity of the children's compulsions. This study's most substantial limitation was the small subject pool, as the sample of 40 children and their parents reduced the likelihood of correctly identifying a significant correlation to 64%. It is unclear whether the findings of this study were due to actual significant relationships or to statistical chance. Despite this drawback, this study remains an important early step in understanding OCD in children. ^